Russian Annexation of Crimea Threatens Drug Therapy for People Suffering From Addictions, Illnesses

The Kyiv Post reported that Russia's annexation of Crimea soon would halt an opioid substitution therapy (OST) program that supplied buprenorphine and methadone to 800 drug-addicted patients in Crimea. Participating in OST programs allowed long-term addicts to avoid illegal drugs, sustain a more normal life, and get medical treatment for related medical conditions like HIV and hepatitis.

Countries across the world use OST as part of a broader HIV prevention strategy. Ukraine had enrolled approximately 8,500 clients in OST programs since 2006, after a sharp increase in injection of homemade opium led to higher HIV incidence in the nation. Ukraine officials reported that OST and other harm reduction strategies had reduced new HIV infections from 7,127 cases in 2006 to 5,847 in 2013.

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An armed escort delivered the substitution therapy drugs from Kharkiv to program sites in Ukraine. Since Russian soldiers and local self-defense and Cossack groups set up roadblocks on roads into Crimea on February 27, no new supplies have arrived on the peninsula. OST clients in Crimea expect substitution drugs to run out in approximately 10 days, since local pharmacies could not stockpile supplies. Roadblocks also affected the supply of medications essential for HIV and TB treatment.

Although the International HIV/AIDS Alliance, which managed OST programs in Ukraine, is trying to restart OST supplies to Crimea, Russian Federation law bans the use of opioid substitutes. Since Crimea voted to rejoin the Russian Federation, doctors and patients involved with OST could face prosecution. Vladimir Stroyevsky, head doctor of the Crimean Narcological Clinic, stated that the clinic already had reduced dosages for OST clients and would provide alternative programs such as rehabilitation or cognitive behavioral therapy. Thus far, Crimean clients were reluctant to move to mainland Ukraine to seek OST, because their families would have to find new means of support.

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